Viglino G, Cancarini G, Catizone L, Cocchi R, de Vecchi A, Lupo A, Salomone M, Segoloni G P, Giangrande A
Servizio di Nefrologia e Dialisi USSL 65, Ospedale S. Lazzaro, Alba.
Adv Perit Dial. 1992;8:269-75.
The impact of peritonitis on CAPD results was evaluated in 1990 pts (mean age +/- SD:58.4 +/- 14.8 yrs, 55.9% males), treated in 30 centres participating in Italian PD Study Group, during 1980-89, with an overall observation period of 3953 years (mean +/- SD 24.1 +/- 22.3 months). The incidence of peritonitis decreases from 1.21 (1980-84) to 0.48 (1985-89) ep/year (overall:0.68) with a significant (P < 0.001) reduction of the probability of developing the first peritonitis episode (FPE) through the same periods. The probability of developing FPE and the relative risk of peritonitis were significantly lower (P < 0.001) in pts for whom CAPD has been the first treatment (80.1%); on the contrary these parameters did not gain significant difference according to sex, age 65 years, diabetes or cardiovascular disease. As far as the organisms responsible for peritonitis are concerned a significant reduction of S. epid. and an increase of S. aureus, other Gram pos. and Pseudomonas was observed in the second 5-yr periods. Peritonitis episodes caused catheter removal in 8.2% of cases and were associated with catheter infection in 10.8% of cases. Peritonitis accounted for 24.2% of hospitalization causes and for 6.7% and 30.0% of death and of drop-out respectively. The probability of death and drop-out was significantly high (p < 0.001) in pts with a peritonitis incidence > 1 ep/year than in those with < 0.5 ep/year. The probability of drop-out due to peritonitis was not higher in diabetic or older patients.
1990例患者（平均年龄±标准差：58.4±14.8岁，男性占55.9%）参与了意大利腹膜透析研究组的研究，于1980 - 1989年期间在30个中心接受治疗，总观察期为3953年（平均±标准差24.1±22.3个月），评估了腹膜炎对持续性非卧床腹膜透析（CAPD）结果的影响。腹膜炎的发生率从1980 - 1984年的每年1.21次降至1985 - 1989年的每年0.48次（总体：0.68次），在同一时期首次发生腹膜炎发作（FPE）的概率显著降低（P < 0.001）。对于首次接受CAPD治疗的患者（80.1%），发生FPE的概率和腹膜炎的相对风险显著更低（P < 0.001）；相反，根据性别、65岁年龄、糖尿病或心血管疾病，这些参数没有显著差异。就引起腹膜炎的微生物而言，在第二个5年期间观察到表皮葡萄球菌显著减少，金黄色葡萄球菌、其他革兰氏阳性菌和假单胞菌增加。8.2%的病例因腹膜炎发作导致导管拔除，10.8%的病例与导管感染有关。腹膜炎分别占住院原因的24.2%、死亡原因的6.7%和退出治疗原因的30.0%。腹膜炎发生率>每年1次的患者死亡和退出治疗的概率显著高于腹膜炎发生率<每年0.5次的患者（p < 0.001）。糖尿病患者或老年患者因腹膜炎退出治疗的概率并不更高。
